Ojectives Low energy hip fractures are one of the greatest causes of morbidity and mortality in orthopaedics. This study aims to evaluate written consent forms with respect to basic standards as set out in the Good Practice in Consent Initiative. In particular the stated risks and benefits of each procedure were assessed. Methods 100 consecutive consent forms were reviewed prospectively. The stated procedure, side and complications were recorded. Appropriate signature and legibility was assessed. 13 consultant orthopaedic surgeons were surveyed to (...) identify what risks and benefits they thought should be stated. Results Of 100 consent forms, 31 were for patients who are unable to consent. All 100 consent forms were correctly filled in with patient details and signed. 98% were legible. All stated the side of the operation. The number of complications listed per form ranged from 4 to 11. Infection, bleeding and thromboembolic complications were stated in the majority of consent forms. In total, 30 different complications were recorded; some were only stated once. Discussion and Conclusions This work suggests consent forms are completed well with respect to patient identifiers, legibility and procedure. The variability of complications stated is vast. We suggest standard pre-printed consent forms containing risks and benefits should be used as this may improve standards of informed consent. This has also been recently supported by the British Orthopaedic Association. (shrink)

Hip fractures are common and serious injuries in the geriatric population. Obtaining informed consent for surgery in geriatric patients can be difficult due to the high prevalence of comorbid cognitive impairment. Given that virtually all patients with hip fractures eventually undergo surgery, and given that delays in surgery are associated with increased mortality, we argue that there are select instances in which it may be ethically permissible, and indeed clinically preferable, to initiate surgical treatment in cognitively impaired patients under the (...) doctrine of presumed consent. In this paper, we examine the boundaries of the license granted by presumed consent and use the example of geriatric hip fracture to build an ethical framework for understanding the doctrine of presumed consent. The license to act under presumed consent requires three factors: patient incapacity, clinical urgency and clarity on the correct course of action. All three can apply to geriatric hip fracture. The typical patient frequently lacks capacity. Delays in initiating surgical treatment are associated with markedly increased mortality rates. Last, there appears to be consensus that surgery is the preferred treatment. Nonetheless, because there is a window of safe delay during which treating physicians can stabilize the patient, address reversible causes of cognitive impairment and identify surrogate decision makers, presumed consent should be invoked only as a method of last resort. A medical situation need not be characterized by risk of imminent and certain death for presumed consent to be relevant. Rather, there are two distinct windows that must be considered: the time interval in which action may be delayed without danger, and the time interval needed to obtain a better form of consent. Presumed consent is appropriate only when the latter exceeds the former. (shrink)

Background Hip fracture repair surgery carries a certain mortality risk, yet evidence suggests that orthopedic surgeons often refrain from discussing this issue with patients prior to surgery. Aim This study aims to examine whether orthopedic surgeons raise the issue of one-year post-surgery mortality before hip fracture repair surgery and to explore factors influencing this decision. Method The study employs a cross-sectional design, administering validated digital questionnaires to 150 orthopedic surgeons. Results A minority of orthopedic surgeons reported always informing (...) patients about the risk of mortality in the year following hip fracture surgery. The main reasons for not discussing this risk were a desire to avoid frightening patients, time constraints, and concerns about undermining patient hope. Orthopedic surgeons reported a medium-high level of perceived self-efficacy, with higher self-efficacy associated with a reduced likelihood of discussing one-year mortality risk. Conversely, older age and holding a specialist status in orthopedic surgery were associated with an increased likelihood of discussing this risk with patients. Conclusions These findings suggest a need for interventions to address communication barriers and ensure consistent provision of essential information to patients undergoing hip fracture surgery. Additionally, they highlight the importance of considering individual factors such as self-efficacy, age, and expertise in designing strategies to improve patient-provider communication in orthopedic care settings. Trial registration : The study doesn`t report the results of a health care intervention. (shrink)

Analysts often use data-driven approaches to supplement their knowledge when selecting covariates for effect estimation. Multiple variable selection procedures for causal effect estimation have been devised in recent years, but additional developments are still required to adequately address the needs of analysts. We propose a generalized Bayesian causal effect estimation algorithm to perform variable selection and produce double robust estimates of causal effects for binary or continuous exposures and outcomes. GBCEE employs a prior distribution that targets the selection of true (...) confounders and predictors of the outcome for the unbiased estimation of causal effects with reduced standard errors. The Bayesian machinery allows GBCEE to directly produce inferences for its estimate. In simulations, GBCEE was observed to perform similarly or to outperform DR alternatives. Its ability to directly produce inferences is also an important advantage from a computational perspective. The method is finally illustrated for the estimation of the effect of meeting physical activity recommendations on the risk of hip or upper-leg fractures among older women in the study of osteoporotic fractures. The 95% confidence interval produced by GBCEE is 61% narrower than that of a DR estimator adjusting for all potential confounders in this illustration. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:I Am Not Sure?Paul E. LevinIt was a beautiful Friday morning, a few weeks into the summer. My schedule appeared lighter than usual and I even envisioned leaving work a bit early. Maybe a challenging bike ride before dinner. I was sitting in the chairman’s office having our weekly meeting. One of our junior faculty members called... he needed help. He was on call and a 32–year–old pregnant woman (...) with a displaced femoral neck fracture had just been transferred to our emergency department (ED). Ms. B tripped in her kitchen last evening. She was unable to stand and was brought to the local ED by ambulance.My colleague was concerned that he wouldn’t be able to successfully reduce the fracture. The long–term prognosis of the hip joint depended on a successful reduction of the femoral neck fracture. In addition, there was an ongoing debate in the orthopaedic literature related to the urgency of operative care to prevent osteonecrosis of the femoral head. I reviewed the x–rays, didn’t anticipate a problem and let him know that I would come to the operating room (OR) to assist. “No”, he responded, “I am not comfortable caring for this patient”. I immediately left the office, went to the hospital and assumed care of the patient. Clearly, my plans for a bike ride were gone, but I had the opportunity to help a woman in need of expert orthopaedic care.Ms. B had been admitted to the obstetrical service. She was a 32–year–old woman of Haitian descent who had recently immigrated to the United States. She had very limited English comprehension and her primary spoken languages were French and Creole. She was alone, in a hospital in a foreign country. She was 24 weeks pregnant with her first child and had no other co–morbidities. Her pregnancy had ben progressing uneventfully.When I first met Ms. B she was lying on a stretcher in an observation unit on the obstetrical floor. She appeared frightened. Two orthopaedic residents were present and obtaining consent for surgical repair of the hip. In their minds there was nothing to discuss, the patient had a displaced femoral neck fracture and needed to have surgery immediately. In their minds, no other options were available and obtaining consent would be straightforward. I introduced myself, sat down on a lab stool by the bed and began a conversation. I needed to meet the patient, understand who she was and discuss treatment. I am not sure that obtaining an informed consent is ever “straightforward” when [End Page 14] a doctor is explaining to a patient that they require emergency surgery. This discussion surely would not be easy or straightforward.We utilized a telephone interpretation service. Every question and response required the transfer of the handset between the patient and physician. Ms. B was in pain and frightened. She immediately expressed concern about her pregnancy and her baby. I arranged for her to meet all of the physicians who would possibly be involved in her care and the care of her baby. Each consultant could explain their area of expertise and potential involvement in the care of Ms. B and her child. She met and had an opportunity to talk with the obstetrician on call, a maternal fetal medicine (MFM) fellow and a neonatologist. I supplied the orthopaedic information. I explained the severity of the injury, the risks of osteonecrosis either with or without surgery as well as concerns over non–union and traumatic arthritis of the hip. Undoubtedly, in a healthy 32–year–old woman who wasn’t pregnant, early surgical intervention would be the most appropriate management in hopes of preserving a normal hip joint. We also discussed the possibility of treating her without surgery. She would be administered pain medication, which were known to be safe during pregnancy, and allowed to begin to ambulate with a walker or crutches. I explained potential problems without surgery and what options would be available to treat any problems that developed with her hip after the child was born. Of course, hip fractures in pregnant woman are very rare, and as a result treating a... (shrink)

The question of whether Do Not Resuscitate orders should be sustained in the operating room was brought to our ethics committee by a pulmonologist and involved one of his patients for whom he serves as a primary care physician. His patient, a woman with chronic obstructive lung disease was electing, for comfort purposes, to have a hip pinning following a fracture. At the same time, she wished to have a DNR order covering her entire hospital stay. The anesthesiologist described (...) her direction as “improper” and refused to participate in surgical procedures if DNR orders extended to the operating room. The patient refused to rescind the order during surgery. As a result, the surgery was canceled to the great chagrin of the patient. (shrink)

May a doctor treat a patient, despite that patient's refusal, when in his professional opinion treatment is necessary? This is the dilemma which must from time to time confront most physicians. An examination of the validity of such a refusal is provided by the present authors who use the case history of a patient refusing treatment, for cancer as well as for a fractured hip, to evaluate the grounds for intervention in such circumstances. In such a situation the patient is (...) said to have a 'false belief' and it is the doctor's duty to try to change that belief in the patient's interest. The false belief is considered here in terms of the liberty principle, the patient's mental competence and on what is called the 'harm principle' (harm to other individuals or to society). Finally the concept of paternalism is examined. The authors conclude that the doctor must attempt to change a false belief, and if this fails he must examine the patient's mental competence to make the decision to refuse treatment. But in the last analysis the doctor may be under an obligation to respect the patient's refusal. Readers might like to look at (or read again) the papers on 'Liberty' and 'Conscience' published in this Journal under the heading Analysis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Dwelling in the GapsGalen SanderlinHave you ever wondered what it would be like to be a mythical being? As a hermaphrodite, I exist in a culture that sees only male or female. Those of us who don’t fit into the rigid sex binary are left out of many of the protections offered to our cousins who more neatly fit the two categories. This leaves an enormous gap in cultural (...) definitions and societal acceptance of my fundamental being.My journey has three main threads: 1) My personal and often rocky self–development, as I have come to understand and accept what it means to be a hermaphrodite, and finding others of my tribe; 2) recognizing the harm done by my medical treatment and actively seeking to change how the medical system treats hermaphrodites, starting from birth onwards; and 3) identifying what was done to me as a human rights violation.I was born in January of 1975. No genetic test was done at the time. My body looked male and my assigned sex/gender was male. As a child, I gravitated toward “male” toys. In 1989, a rural– MD noted that I was not experiencing puberty like my peers and she recommended that my parents take me to a teaching hospital in Seattle for tests. A pediatrician referred me to the adolescent medical division, and from there I was referred to an endocrinologist. After conducting many invasive tests, including drawing blood and comparing my testicles to a bead ring of ersatz testicles, the endocrinologist diagnosed me with Klinefelter’s Syndrome and a karyotype of 47,XXY. I was prescribed testosterone injections to affirm and strengthen the male identity I was assigned at birth and to prevent my body from developing secondary female sex characteristics (breasts and hips).Soon after the shots started I bulked up, adding muscle and hair everywhere. I also became dangerously aggressive and moody. I began to have serious self–esteem issues and a drastic increase in risk–taking behavior as my body was subjected to medical intervention that my parents innocently followed.The prescribed hormone treatment fractured my psyche—what I know now to be a common defense mechanism experienced in trauma survivors. The portion of my consciousness that existed prior to testosterone became deeply buried to prevent harm, and I experienced the emergence of a new “entity.” With each change in prescription, new fractures occurred: testosterone cypionate to enanthate shots, to patches, to gels.The physicians did not consider my feelings or preferences during recommendations or treatment. I feel I was forced into a “male” body based on a medical emergency they created to ease societal concerns.Last February I decided to stop hiding. Tearing the mask off has brought a flood of emotions hidden behind old traumas. I’d been living openly as an intersex person, but still deeply closeted, if not from the public—worse, from myself.Here is the writing that came pouring out of me as I’ve been accessing my repressed memories:I felt the first stirrings of my existence in August of 1989, like a fleeting visage of a long lost lover passing just out of view. The timing of the universe—Out of the infinite we are born, but in this case the body we are to occupy was already housing many other souls. Is this some mistake? Asked to be patient I waited... Late in the year of 1989 I was borne on testosterone wings into an imaginary masculine role/body.Molded in the image of Adonis, Hermes was forced to submit. No longer sexless or ageless—lost in a sea of supposed pressures and roles. My assumed gender [End Page E10] was male. Why!?! Screaming, thrashing, and damaging all around me, no way to express the horror of being so brutally manhandled.My guide Galen/Juniper were excised from our psyche—lost behind a barrier. The only solace was a shared beat: 1,2,3,4 over and over. Was this the pounding of our heart? Thank god for our love of music least we lose ourselves entirely.Why do they insist on calling me Galen? I no longer knew who this was. I... (shrink)

Hard-nosed physicists are content with elementary quantum mechanics as it is. Deep searchers desire a deeper comprehension of the theory or rather of reality. Observable internal correlations in micro-systems and external correlations between widely separated parts can be calculated at the office. But how can for that purpose indispensable information be observed, coded and stored and transmitted in the real systems?A spectacular example is Einstein-Podolsky-Rosen entanglement. How can one part know what has been or will be happening at the other (...) distant part? (shrink)

Abstract: How it is that one's own thoughts can seem to be someone else's? After noting some common missteps of other approaches to this puzzle, I develop a novel cognitive solution, drawing on and critiquing theories that understand inserted thoughts and auditory verbal hallucinations in schizophrenia as stemming from mismatches between predicted and actual sensory feedback. Considerable attention is paid to forging links between the first-person phenomenology of thought insertion and the posits (e.g. efference copy, corollary discharge) of current cognitive (...) theories. I show how deficits in the subconscious mechanisms regulating inner speech may lead to a 'fractured phenomenology' responsible for schizophrenic patients' reports of inserted thoughts and auditory verbal hallucinations. Supporting work on virtual environments is discussed, and lessons concerning the fixity of delusional belief are drawn. (shrink)

Cet ensemble ne cherche pas à gommer par des ponts et des raccords le disparate des préoccupations, l'aléatoire des sollicitations. Il forme toutefois un ouvrage qui a ses obsessions, ses retours, ses insistances. Le cours de l'Histoire et les philosophies qui ont cherché à le comprendre, la place dominante prise aujourd'hui par le discours économique, les quêtes extrêmes de sens, aux limites de la raison, la fidélité à des causes qui ont pu passer pour utopiques, voilà quelques tracés qui se (...) rendent visibles. Quoi de commun entre l'espoir fou d'Antonin Artaud de "guérir la vie" en transgressant les frontières de la rationalité occidentale, et la tentative d'Emmanuel Lévinas de fonder l'éthique sur le visage de l'autre pour subvertir la tyrannie de l'universel et de l'impersonnel? Quoi de commun entre la temporalité anhistorique de l'Islam et l'espoir militant d'une libération des femmes qui ouvre une autre Histoire? Dans le choc des réflexions aux prises avec l'inattendu, dans l'irruption des conjonctures inquiétantes, ces effets de brisures, ces fractures du temps, ne contredisent pourtant pas un souffle d'irréversible, qui confirme ce que les pensées de l'Histoire et leur foi dans l'avenir ont pressenti. J.J.G. (shrink)

This brief paper builds on my recently published work on financial capitalism. My objective here is (a) to sketch an account of the primary social features of post-1970s financialised capitalism, (b) to identify select dynamics or mechanisms that have resulted in these features, (c) to outline a programme of research to enhance our explanatory understanding of the ‘fractured society’ via the sociological concepts of structure, culture and agency, and (d) to broach, characterize and assess likely prospects and triggers for the (...) accomplishment of a credible, defensible post-capitalist societal formation. (shrink)

This paper investigates the lived experience of alienation as a form of mental strife or pathology as it is connected to the digitalization of modern life. To do so, I deploy the concept of affordances from ecological psychology, phenomenology, and embodied cognition. I propose an affordance-based model for understanding digitalized alienation. First, I argue that the lived sense of alienation is best understood as a fracturing of the affordance space, where possibilities for action are lived as disconnected from one another (...) and therefore from one’s personal development and search for meaning. Using this model, I show how the process of digitalization can lead to a lived sense of alienation for modern subjects. On this model, digitalization is alienating insofar as it fractures the affordance space into disconnected fields that invite determinate, separate, and repeatable tasks—swiping, clicking, scrolling, etc.—rather than offering opportunities for the development of new cognitive and bodily skills that are mutually informing and enriching across different affordance fields. (shrink)

Unity, commonality, and agreement are generally understood to be the basis, or the aim, of community. This paper argues instead that disagreement and fracture are inherent to, and provide the expression of difference within, community. Drawing on the experience of race relations in Australia, this paper proposes that ongoing resistance and disagreement by Aboriginal groups against non-Aboriginal law and culture has enabled an unworking of homogenizing and totalizing forces which destroy alterity within community.

Emissions arising from the production and consumption of food are acknowledged as a major contributor to climate change. From a consumer’s perspective, however, the sustainability of food may have many meanings: it may result from eating less meat, becoming vegetarian, or choosing to buy local or organic food. To explore what food sustainability means to consumers, and what factors lead to changes in food practice, we adopt a sociotechnical approach to compare the food consumption practices in North West England with (...) two differing consumer groups. The first, supermarket shoppers ‘embedded’ in the mainstream food regime; and the second, who self-identify as sustainable food practitioners, and who perform a range of sustainable food consumption practices. We examine how our two groups experience changes in food practices and identify ‘fractures’ stemming from lifecourse and public events that emerge as points where change might occur. We suggest that ‘sharing spaces’ would be one possibility for prompting and nurturing fractures that can lead to greater sustainability in food practices. (shrink)

The Fractured Self in Freud and German Philosophy examines Freud's transformation of German philosophical approaches to freedom, history, and self-knowledge; defends a theory of situated knowledge and agency; and considers the relevance of Freudian thought for contemporary cultural issues.

L'Histoire occidentale, devenue planétaire, donne aujourd'hui des signes d'épuisement. Elle semble incapable d'imaginer son avenir. Sera-t-il un crépuscule interminable, ou verra-t-il une nouvelle aurore? Depuis longtemps déjà, au-dessus de la " Terre du Soir ", le soleil des grands principes qui firent époque, décline. Sommes-nous sur le point d'entrer dans une longue " nuit du monde ", où seuls nous guideront quelques feux clignotants et nos divers écrans allumés en permanence? Les utopies sur la " fin de l'Histoire " se (...) sont successivement effondrées. -N'est-il pas également utopique d'espérer un " nouveau commencement "? En quel espace une " autre Histoire " se situerait-elle? Par delà celle de l'Etre, qui s'achèverait dans la gigantesque Machinerie technologique ; ou bien, parallèlement à son ultime époque, comme son envers ou son Histoire secrète? Le plus clair de l'interprétation heideggérienne de Nietzsche sert à poser les bases de la " métaphysique achevée ", que régit la " volonté de volonté ". Cette lecture est-elle tenable? Et, bien plus, la métaphysique en son essence est-elle oubliable, achevable? Un tel adieu est-il possible? Si l'on préfère parler ici de " fracture de l'Histoire " c'est que rien de ce qui a fait date de façon essentielle ne s'achève : les brèches de l'Histoire ne se comblent pas, mais se recomposent imperceptiblement, laissant entrevoir de l'extra-historique ou de l'inachevable. Il ne s'agit pourtant pas dans ces essais de simplement " critiquer Heidegger ", mais de réentendre ou de prolonger les questions invieillissables qu'il nous a léguées - afin d'élucider s'il se peut la lente, douloureuse et incertaine mutation de l'époque. (shrink)

An investigation of Benjamin’s conception of the subject as fractured via a reading of Benjamin’s use of Freud, this book engages Benjamin’s writing on sovereignty and myth in the Baroque and analyzes these themes in the context of Benjamin’s writing on the 19th century.

Quelle est la pertinence de l'expression «fracture numérique» qui sert à désigner des inégalités entre populations, en prenant en compte le niveau technologique, le taux de connectés, le nombre de machines, les budgets consacrés aux TIC, etc.? S'agit-il d'un concept qui pourrait servir à définir des politiques ou des investissements? En fait, il apparaît que la fracture numérique, tant entre les pays du Sud et les pays du Nord qu'au sein d'un même pays , n'est qu'une transposition d'autres (...) inégalités ou phénomènes d'exclusion, comme le chômage, la précarité, la prolétarisation, etc. Porter sur les équipements et les pratiques liés à l'informatique et aux réseaux un regard exclusif, en les isolant du contexte global économique et social, revient à admettre que le développement des TIC serait indépendant de ces facteurs généraux, qu'il existerait un progrès technologique applicable en tous lieux de la même manière et qu'à travers les TIC, et leur seule implantation, on pourrait remédier aux inégalités et au sous-développement.What is the relevance of the term "digital divide" is used to denote inequalities between populations, taking into account the level of technology, the rate of users, number of machines, ICT budgets, etc..? Is it a concept that could be used to define policies or investments? In fact, it appears that the digital divide, both between the South and the North and within the same country , is a transposition of other inequalities or exclusion phenomena such as unemployment, precariousness, proletarianization, etc.. Wear on equipment and practices related to computer networks and an exclusive look, isolating the overall economic and social context, is to recognize that ICT development is independent of these general factors, that there is an improvement technology applicable everywhere in the same way and that through ICT, and their only implementation could address inequalities and underdevelopment. (shrink)

This paper examines the plays of African-American playwright Adrienne Kennedy, Funnyhouse of a Negro (1962) and The Owl Answers (1963), which remain important for their engagement with notions of African-American identity, resistance and agency through their attention to mixed race female characters or mulattos who experience bodily and psychological traumas that demonstrate the abuse of the colonized on a deeply visceral level. Kennedy's plays have remained controversial because of their failure to comply with the nationalistic orientation of the Black Arts (...) Movement (BAM) of 1960s America. I aim to examine these plays through a framework of postcolonial-feminist performance analysis that finds its way back to histories of colonization and slavery, enabling through such returns, a compelling critique of the manoeuvrings of racial hierarchies and power imbalances. As well, I argue that Kennedy's protagonists are de-essentialized fractured beings who fail to embody either White superiority or Black nationalist pride, as they oscillate between two polarities. Such failure (on the part of Kennedy's mulattos) allows for a strategic de-essentialization of identity that interrogates fixed categorization. As well, through a form that is fluid, fragmented and blurs the distinctions among history, memory, space and time, her works impart political agency to the characters and enable an empowered sense of the ‘self-in-process.’. (shrink)

Cet article traite la problématique du facteur humain dans la société en réseau en mettant en évidence que les TIC sont à la fois créatrices et destructrices de lien social. Il propose une approche de la fracture numérique selon deux niveaux: - un accès inégalitaire à Internet et aux TIC; - des savoirs et savoir-faire insuffisants pour communiquer dans une société désormais régie par la manipulation et les mécanismes de génération de la connaissance. Il prend comme exemple référentiel la (...) génération Internet née de la double médiation technique et sociale caractéristique du lien social engendré par l'usage des TIC. Et, il situe ainsi la véritable origine de la fracture numérique dans les inégalités socio-économiques et culturelles qui existaient pour la plupart avant l'introduction des TIC et la mise en réseau de la société.This paper addresses the problem of the human factor in the network society by highlighting that ICTs are both creative and destructive social links. It proposes an approach to the digital divide in two levels: - unequal access to the Internet and ICT - knowledge and skills sufficient to communicate in a society now governed by the manipulation and generation mechanisms of knowledge. He takes as an example the Internet generation born repository of double mediation technical and social characteristics of social ties generated by the use of ICT. And it is thus the true origin of the digital divide in the socio-economic and cultural existed mostly before the introduction of ICT and networking company. (shrink)

Mitochondrial dysfunction underlies a vast array of chronic disorders across the life span. The asymptotic limit theorems of information and control theories, supplemented by symmetry-breaking phase transition arguments adapted from physical theory, give deep insight into canonical mechanisms of cognition and regulation associated with such dysfunction. The probability models studied here can provide a foundation for the development of statistical tools useful in clinical and public health address of those disorders.

ArgumentThis article explores the scientific partnership between geology professor Gerard De Geer and his wife Ebba Hult following their marriage in 1908. De Geer was an influential participant in Swedish academia and international geology. Hult worked as his assistant until his death in 1943. The partnership was beneficial for both spouses, in particular through the semi-private Geochronological Institute, which they controlled. The article argues that marriage was a culturally acknowledged form of collaboration in the academic community, and as such it (...) offered Hult access to geological research. However, the paper also argues that the gendered scientific institutions produced a fractured position. Partly, Hult managed to create her own role as researcher in geochronology. As a woman and a wife, however, she never moved out of her husband's shadow. Gender is understood as a relational category: Hult was an outsider who participated partially in standardized structures which gave great power to her husband and other men. The fact that she shared this status with other women in Swedish science at the time indicates the structural nature of their position. Nevertheless, they all had individual trajectories through academia. Indeed, the study of collaborative couples illustrates the multifaceted links between individual actions and the historical context of science. (shrink)

Le potentiel de développement porté par les TIC reste quelque chose de purement théorique pour des millions de personnes compte tenu de l'existence de la fracture numérique qui sépare les « inforiches » des « infopauvres ». Dans la perspective de la construction d'une société de l'information inclusive, la question de l'accès universel aux TIC est donc centrale, notamment pour les pays africains. Cette problématique ne doit cependant pas être réduite à la question de la disponibilité des infrastructures de (...) télécommunications; elle doit prendre en compte l'accès réel, c'est-à-dire les usages. Afin de résoudre les problèmes de diverses natures interdisant l'appropriation des TIC par le plus grand nombre, il faut aller au-delà de la régulation par le marché et mettre en oeuvre de vigoureuses politiques publiques visant à faire de l'accès universel une réalité concrète pour tous ceux dont les chances de bénéficier pleinement des opportunités offertes par la société de l'information sont aujourd'hui hypothéquées.The potential of ICT-led development remains something purely theoretical for millions of people due to the existence of the digital divide between the "haves" from "have-nots". In view of the construction of the information society inclusive, the issue of universal access to ICTs is central, especially for African countries. This issue should not be reduced to the question of the availability of telecommunications infrastructure, but must take into account the actual access, that is to say, uses. To solve problems of various kinds prohibiting the appropriation of ICTs by the largest number, you must go beyond regulation by the market and implement vigorous public policies to make universal access a reality concrete for all those whose opportunities to benefit fully from the opportunities offered by the information society are now mortgaged. (shrink)

A recent conference had as a theme, Ethics in the Fractured State. That theme presumes that there is a fractured state – if not everywhere then somewhere, if not now, then soon. This paper looks at the nature of the fracture and at the implications for the teaching of ethics. Three important lines of fracture – plural, secular, anti-business – are considered in the paper, each described and distinguished separately. The fracture makes ethics more relevant not only (...) in business schools but also in professional faculties such as engineering and pharmacy. The recent rise in anti-business sentiment and its potential impact for the teaching of ethics, especially business and professional ethics, is discussed. The focus is on the implications for the teaching of applied ethics. (shrink)